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Review: antibiotics are only slightly more effective than placebo for clinically diagnosed acute rhinosinusitis in adults

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J Young

Dr J Young, University Hospital Basel, Basel, Switzerland;


Are antibiotics effective for treatment of adults with clinically diagnosed acute rhinosinusitis? Are there any signs or symptoms that identify patients most likely to benefit from antibiotics?


Studies selected compared an antibiotic with placebo in adults with clinical signs and symptoms of acute rhinosinusitis. Studies involving diagnosis by imaging, laboratory tests, or bacterial culture were excluded. Outcome was proportion of patients cured.


Medline, EMBASE/Excerpta Medica, Cochrane Central Register of Controlled Trials, and reference lists were searched for randomised controlled trials (RCTs). 10 RCTs providing 11 comparisons (n = 2782, median age 35 y [adolescents were included in 6 RCTs]) met the selection criteria. All trials were double-blinded; loss to follow-up was <4% in all but 2 trials and 3.6% overall. Duration …

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  • Source of funding: Santésuisse, Gottfried and Julia Bangerter-Rhyner-Foundation, and Swiss National Research Foundation.